Contract Pharmacy Details

THRIFTY PAYLESS, INC.
CH090250 CLINICAS DE SALUD DEL PUEBLO,Inc.

Covered Entity Details

Entity Name

CLINICAS DE SALUD DEL PUEBLO,Inc.

Subdivision Name

Innercare K Street

Type

HRSA-Funded Health Center

340B ID

CH090250

Entity Address

1166 K St
Brawley, CA 92227-2737

Grant Number

H80CS00733

Participating Start Date

12/1/1992

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

THRIFTY PAYLESS, INC.

Pharmacy Address

RITE AID #6515
211 WEST BIRCH STREET
CALEXICO, CA 92231

Pharmacy Comments

Contract Details

Approval Date

12/3/2012

Contract Begin Date

1/1/2013

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

YVONNE BELL, CEO
(760) 344-9951 Ext: 10102

Contract Pharmacy Representative

Rite Aid
Ruth Lightner, Director
(717) 731-6524

Signed By Date

10/9/2012

340B Drug Pricing Program Database